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Abstract Number: 2777

Factors Associated with Readiness for Adopting Osteoporosis Treatment Change

Maria I. Danila1, Elizabeth J. Rahn2, Amy S. Mudano1, Ryan C. Outman3, Peng Li4, David T. Redden4, Fred A. Anderson5, Susan L. Greenspan6, Andrea Z. LaCroix7, Jeri W. Nieves8, Stuart L. Silverman9, E.S. Siris10, Nelson B. Watts11, Sigrid Ladores12, Karen Meneses12, Jeffrey R. Curtis3 and Kenneth Saag3, 1University of Alabama at Birmingham, Birmingham, AL, 2Department of Medicine, Division of Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, 3Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, 4Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, 5University of Massachusetts Medical School, Worcester, MA, 6Medicine, University of Pittsburgh, Pittsburgh, PA, 7Group Health Cooperative, Seattle, WA, 8Helen Hayes, West Haverstraw, NY, 9Cedars-Sinai Medical Center, Los Angeles, CA, 10Columbia University Medical Center, New York, NY, 11University of Cincinnati, Cincinnati, OH, 12Nursing, University of Alabama at Birmingham, Birmingham, AL

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: fracture risk and osteoporosis

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Session Information

Date: Tuesday, November 7, 2017

Session Title: Patient Outcomes, Preferences, and Attitudes II

Session Type: ACR Concurrent Abstract Session

Session Time: 2:30PM-4:00PM

Background/Purpose:  Understanding factors associated with the readiness for adopting osteoporosis treatment change may inform the design of behavioral interventions to improve osteoporosis treatment uptake in women at high risk for fracture.

Methods:  US women in the Global Longitudinal Study of Osteoporosis (GLOW) with prior self-reported fractures and not currently using osteoporosis therapy were eligible to participate in the Activating Patients at Risk for OsteoPOroSis (APROPOS) Study. Participants’ readiness for behavior change was assessed using a modified form of the Weinstein Precaution Adoption Process Model (PAPM). We defined pre-contemplative participants as those who self-classified in the unaware and unengaged stages of PAPM. Contemplative participants were defined by the undecided, decided not to act, and decided to act stages of PAPM. Bivariate tests and stepwise multivariable logistic regression evaluated the following factors associated with these two levels of readiness for behavior change: sociodemographic characteristics, health literacy, self-reported history of depression and dementia, previous treatment for osteoporosis, whether participants had been told they had osteoporosis/osteopenia, and whether they had concerns about osteoporosis.

Results:  A total of 2,684 women were enrolled in APROPOS. Participants were 95% Caucasian, with a mean(SD) age 74.9(8.0) years and 77% had some college education. Overall, 25% (N=544) self-classified in the contemplative stage of behavior change. Compared to women who self-classified as pre-contemplative, contemplative women were more likely to be concerned about osteoporosis (adjusted OR[aOR]=3.2, 95% CI 2.3-4.4) and to report prior osteoporosis treatment (aOR 4.3, 95% CI 3.1-6.0). Individuals who had been told they had osteoporosis had a 12.4 fold odds to be in the contemplative group (95% CI 8.5-18.1), while those who had been told they had osteopenia had 4.1 fold odds to be in the contemplative group (95% CI 2.9-5.9).

Conclusion:  Among women with high risk of future fracture, having been told by a health care provider that they had osteoporosis/osteopenia was independently associated with considering taking medications for osteoporosis. Our results suggest that in considering osteoporosis intervention design efficiency and effectiveness, women’s recognition of a diagnosis of osteoporosis/osteopenia are critical components to be considered when attempting to influence stage of behavior transitions.


Disclosure: M. I. Danila, None; E. J. Rahn, None; A. S. Mudano, None; R. C. Outman, None; P. Li, None; D. T. Redden, None; F. A. Anderson, Millenium Pharmaceuticals, 5; S. L. Greenspan, Amgen, 2,Lilly, 2; A. Z. LaCroix, Amgen, Pfizer, Sermonix, 9; J. W. Nieves, None; S. L. Silverman, Amgen, Lilly, 2,Amgen, 5; E. S. Siris, None; N. B. Watts, OsteoDynamics, 1,Shire, 2,OsteoDynamics, 4,AbbVie, Amgen, Janssen, Merck, Radius, Sanofi, 5,Amgen, Shire, 9; S. Ladores, None; K. Meneses, None; J. R. Curtis, Amgen, 2,Amgen, 5; K. Saag, Amgen, Lilly, Merck, 5,Amgen, Lilly, Merck, 2.

To cite this abstract in AMA style:

Danila MI, Rahn EJ, Mudano AS, Outman RC, Li P, Redden DT, Anderson FA, Greenspan SL, LaCroix AZ, Nieves JW, Silverman SL, Siris ES, Watts NB, Ladores S, Meneses K, Curtis JR, Saag K. Factors Associated with Readiness for Adopting Osteoporosis Treatment Change [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/factors-associated-with-readiness-for-adopting-osteoporosis-treatment-change/. Accessed February 6, 2023.
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